Colonoscopy - Colon Cancer - Importance of Proper Tattoo Technique

A case of a middle aged patient who underwetn right hemicolectomy for colon cancer is presented. The specimen, resected during surgery, did not show cancer, therefore, the patient was referred to our center. The cancer found two folds distal to the anastomosis.

Tattoo to assist surgery to find the cancer is different from a tattoo placed when referred to EMR.

Tattoo for surgery: Place 3-4 tattoos circumferentially 1-2 folds distal to the cancer to help the surgeon locate the tumor easily; create a saline bleb and fill it with the tattoo; start in the dependent portion first so that if the dye spills, it does not obscure the view (find dependent portion by flushing saline to locate the dependent portion).